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PWE-049 Five Year Retrospective Morbidity and Mortality Figures for Colonoscopy in a District General Hospital
  1. K M Barnett1,
  2. C Gordon1,
  3. S Weaver1
  1. 1Gastroenterology, Royal Bournemouth Hospital, Bournemouth, UK

Abstract

Introduction Between 1 July 2007 and 31 August 2012, 15284 colonoscopies were performed by Gastroenterologists, Colorectal Surgeons, Gastroenterology and Surgical trainees and Nurse Endoscopists. Over the 5 year period our unit has an average caecal intubation rate of 93.53% and polyp detection rate of 36.54% demonstrating colonoscopy performance that meets current national guidelines for performance indicators in endoscopy. The current JAG guidelines for complications of colonoscopy are perforation rate < 1:1000, post polypectomy bleeding requiring transfusion < 1:100 and post polypectomy perforation < 1:500.

Aim To determine the complication rate and 30 day mortality of colonoscopy performed in a district general hospital (DGH).

Methods Using the hospital IT system and a coding search, patients were identified if they had died within 30 days, were readmitted or went to theatre within 8 days of a colonoscopy. Case notes were then reviewed to assess if any event was directly related to the procedure or intervention undertaken.

Results In the 62 month period one death occurred from sepsis due to perforated diverticular disease (DD) (1/15284). In this time frame 4023 patients were diagnosed with DD giving a risk for perforation and death in DD of 1:4000.

Perforation: occurred in 13 patients (1:1175), the causes listed in table 1.

Abstract PWE-049 Table 1

Causes of perforation

One patient with Crohn’s disease of the terminal ileum (TI) developed severe pain post procedure requring a laparotomy where the cause was found to be tearing of an adhesion to the TI, no perforation was seen 1/15284.

Bleeding Polyps were found in 5966 patients. Post polypectomy bleeding requiring admission occurred in 27 patients (1:220 patients). 18 were observed for 24–48 hours without any intervention. 9 required transfusion (1:663). Of these patients, one required a right hemicolectomy for haemostasis and one required angiogram and embolisation, the remaining managed conservatively. Post biopsy bleeding occurred in 4 patients out of 8702 who were biopsied (1:2175)

Post polypectomy syndrome occurred in 3 patients of 5966 patients with polyps (1:2000)

Pain post colonoscopy requiring admission occurred in 12 patients (1:1273). Pain was attributed to air insufflation with radiology excluding perforation.

Bowel preparation with Fleet resulted in one patient developing end stage renal failure due to phosphate nephropathy (1:4715), This preparation is no longer in use.

Conclusion Few papers are published on the complication rates of colonoscopy at DGHs. This data gives valuable long term insight into the rate of serious complications and demonstrates safe colonoscopy at this DGH within current JAG Guidelines.

Disclosure of Interest None Declared.

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